Healthcare Provider Details

I. General information

NPI: 1568722072
Provider Name (Legal Business Name): CENTRA HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2012
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 OAK LN
LYNCHBURG VA
24503-2501
US

IV. Provider business mailing address

1331 OAK LN
LYNCHBURG VA
24503-2501
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-2422
  • Fax: 434-384-3168
Mailing address:
  • Phone: 434-200-2422
  • Fax: 434-384-3168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number0201004455
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TABITHA CULBERTSON
Title or Position: HOSPITAL PRESIDENT
Credential:
Phone: 434-200-3014